Jejunal Leiomyosarcoma with Bleeding and Intussusception: Report of a Case

空腸平滑肌肉瘤併發出血及腸套疊：－病例報告

魏克承(Keh-Cherng Wey) ； 牟聯瑞(Lein-Ray Mo) ； 林瑞昌(Ruey-Chang Lin) ； 郭振源(Jenn-Yuan Kuo) ； 張國寬(Kuo-Kwan Chang) ； 丘文斌(Man-Pun Yau) ； 卓啓裕(Chi-Yu Cho) ； 蔡建中(Chien-Chung Tsai)

《中華民國消化系醫學雜誌》 13卷1期 (1996/03) Pp. 46-52

https://doi.org/10.6557/GJTb.199603_13(1).0007

摘要

小腸平滑肌肉瘤是一種罕見的腫瘤。臨床上症狀以解黑便、腹痛及可模到之腹部腫瘤為主。我們提出一位空腸平滑肌肉瘤之病例，此患者因反覆解黑便而住院。上、下消化道內視鏡及上、下腸系膜血管攝影均未發現出血點。小腸鋇劑攝影顯示，在空腸處有阻塞之現象，同時並懷疑有腸套疊；腹部電腦斷層攝影發現，在小腸有一腫瘤；同位素紅血球掃描發現空腸處出血。病人接受手術時，先以徒手進行腸套疊之還原，再切除腫瘤，其症狀隨之緩解。因此腫瘤之症狀不專一，且大多數診斷方法之敏感度不高，故常易延遲診斷，臨床上實不宜掉以輕心。唯一有效的處理方法為手術切除。本文將討論小腸平滑肌肉瘤的診斷、解剖病理及處理方法。

關鍵字

平滑肌肉瘤 ； 腸套疊

並列摘要

Leiomyosarcoma of the small intestine is an uncommon tumor. A case of jejunal leiomyosarcoma with bleeding and intussusception is herein presented. The patient was admitted due to recurrent black stool passage. Panendoscopy, colonscopy, superior and inferior mesenteric arterial angiography revealed negative findings. Small bowel series revealed obstruction at jejunum and intussusception was highly suspected. Computed tomography (CT) showed a solid mass engulfing the small bowel loop. Scintigraphy with Technetium-labeled red blood cells showed jejunal bleeding. Manual reduction of intussusception and segmental resection of the jejunum were successfully performed. Delayed diagnosis is common after a long period of vague symptoms and signs of the disease. Although this lesion is not common, clinicians should be on the alert for a patient with this clinical picture.

並列關鍵字

leiomyosarcoma ； intussusception